TAME: Destruction or Repair? Ischemia or Reperfusion? [Regenerative Injection Therapy]

Author: Bow Wang, M.D.

Before departing for VENTI in Tokyo, Japan last month, I had an in-depth discussion with Dr. Pan Chien-li, a renowned rehabilitation physician and pain medicine expert from Taiwan, regarding whether Transarterial Microembolization (TAME) primarily repairs or damages injured structures, and whether it causes local tissue ischemia (de-perfusion) or increased perfusion (re-perfusion) on imaging. I also took this opportunity to consult with the original author, Dr. Yuji Okuno, and combined my own practical treatment experience with research published by foreign scholars, which I have summarized below.

Dr. Okuno stated that, according to current literature, no patient with tendinopathy has been diagnosed with TAME… This can lead to tendon rupture. Conversely, TAME has the potential to promote tendon normalization. A case report I co-authored with Dr. Song Kang this year also presented the same results.

In the abstract session of the VENTI conference, Dr. Shinichi Iwakoshi from Japan also reported the results of a study on paradoxical increases in arterial perfusion in patients with hand joint pain after TAME treatment. We look forward to his formal publication.

In the workshop on US-guided sTAME (ultrasound guided simplified embolization) held last week, Dr. Liang Gengwei also demonstrated imaging changes showing increased local arterial perfusion in patients with plantar fasciitis after perfusion treatment.

Besides the fact that several studies have shown that due to structural differences and usage... In addition to factors such as the ability of transient embolic agents to selectively embolize malformed angiogenesis, allowing normal arteries to recanalize quickly without damage, Dr. Okuno also mentioned at the CIRSE conference that he dedicated three extra years to studying the vascular mechanism of TAME (tumor angiogenesis) and its relationship to chronic inflammation and vascularity (his original research focused on tumor angiogenesis).

He believes that in a state of chronic inflammation, micro-AV shunts form between malformed angiogenesis and early venous drainage, causing blood to be "stolen" (vascular steal phenomenon). By embolizing malformed angiogenesis with TAME, the blood flow shunts caused by micro-AV shunts can be relieved, allowing local tissues to restore normal perfusion.

[Regenerative Therapy] The field of TAME (Transvascular Angiogenesis Injection) is quite vibrant in Taiwan, and I was delighted to have in-depth exchanges with many experts in proliferative angiogenesis treatment, including Dr. Tsai Sheng-heng, Dr. Liao Wei-cheng, Chairman Wang Wei-chuan, and Dr. Pan Chien-li. TAME and regenerative injection are not contradictory in terms of vascular management concepts; for patients with chronic inflammation exceeding three months and significant local angiogenesis, I first use TAME to clear the obstructed blood vessels, and then use regenerative injection to initiate the repair mechanism.

Many patients have also reported significant improvement after TAME treatment, leading to further integration with regenerative injection. The improvement is even greater. By combining different treatment methods, there is a chance to bring better prognosis to patients, and Bow Wang, M.D. is also conducting related research.